PURPOSE: The main objective of this study was to determine the relationship between quality of life, social functioning, depressive symptoms, self-efficacy, physical function, and socioeconomic status (SES) in community-dwelling older adults.METHODS: A cross-sectional design was used to examine the relationships. A sample of 193 community-dwelling older adults completed the measurements. Structural equation modeling with full information maximum likelihood in LISREL was used to evaluate the relationships between the latent variables (SES, social functioning, depressive symptoms, self-efficacy, physical function, and quality of life).RESULTS: The path analysis exhibited significant effects of SES on physical function, social functioning, depressive symptoms, and self-efficacy (γ = 0.42-0.73), and significant effects in regard to social functioning, depressive symptoms, and self-efficacy on quality of life (γ = 0.27-0.61). There was no direct effect of SES on the quality of life. The model fit indices demonstrated a reasonable fit (χ (2) = 98.3, df = 48, p < 0.001), matching the relative Chi-square criterion and the RMSEA criterion. The model explained 55.5 % of the variance of quality of life.CONCLUSIONS: The path analysis indicated an indirect effect of SES on the quality of life by social functioning, depressive symptoms, and self-efficacy in community-dwelling older adults. Physical function did not have a direct effect on the quality of life. To improve the quality of life in older adults, additional focus is required on the socioeconomic psychosocial differences in the community-dwelling older population.
LINK
Specific approaches are needed to reach and support people with a lower socioeconomic position (SEP) to achieve healthier eating behaviours. There is a growing body of evidence suggesting that digital health tools exhibit potential to address these needs because of its specific features that enable application of various behaviour change techniques (BCTs). The aim of this scoping review is to identify the BCTs that are used in diet-related digital interventions targeted at people with a low SEP, and which of these BCTs coincide with improved eating behaviour. The systematic search was performed in 3 databases, using terms related to e/m-health, diet quality and socioeconomic position. A total of 17 full text papers were included. The average number of BCTs per intervention was 6.9 (ranged 3–15). BCTs from the cluster ‘Goals and planning’ were applied most often (25x), followed by the clusters ‘Shaping knowledge’ (18x) and ‘Natural consequences’ (18x). Other frequently applied BCT clusters were ‘Feedback and monitoring’ (15x) and ‘Comparison of behaviour’ (13x). Whereas some BCTs were frequently applied, such as goal setting, others were rarely used, such as social support. Most studies (n = 13) observed a positive effect of the intervention on eating behaviour (e.g. having breakfast) in the low SEP group, but this was not clearly associated with the number or type of applied BCTs. In conclusion, more intervention studies focused on people with a low SEP are needed to draw firm conclusions as to which BCTs are effective in improving their diet quality. Also, further research should investigate combinations of BCTs, the intervention design and context, and the use of multicomponent approaches. We encourage intervention developers and researchers to describe interventions more thoroughly, following the systematics of a behaviour change taxonomy, and to select BCTs knowingly.
DOCUMENT
Background and ObjectivesThis qualitative study applied a resilience perspective to socioeconomic inequalities in the functioning of older adults. We aimed to gain insight into how some older adults managed to age successfully despite having a low socioeconomic position (SEP) throughout their lives.Research Design and MethodsSemistructured interviews were conducted with 11 resilient adults over the age of 79 years participating in the Longitudinal Aging Study Amsterdam, the Netherlands. Participants were defined as resilient on the basis of having a low lifetime SEP and favorable trajectories of physical, mental, and social functioning. Grounded Theory coding techniques were applied to identify themes reflecting distinct ways in which participants dealt with what they indicated were the most significant adversities in their lives. The analysis focused on experiences linked to socioeconomic conditions.ResultsSix themes reflecting psychological, behavioral, and social factors were derived from the data: drawing support from social contacts; investing in younger generations; taking actions to manage or improve socioeconomic conditions; putting the impact of a low SEP into perspective; persevering; and resigning oneself to adversity.Discussion and ImplicationsFindings suggest that successful aging despite a low SEP throughout one’s lifetime requires considerable psychological and social resources. In addition, resignation and specific manifestations of generativity are identified as new elements of resilience. These findings may help to reduce the stereotyping of older adults with a low SEP, and nuance the heroic image of resilience as something that is primarily attributable to extraordinary individual abilities or efforts.
DOCUMENT